At the end of last week I had not one but two fertility clinic visits, at two different clinics. On the one hand things went “well” – I was happy with the doctors I saw and their explanations of their findings – but on the other hand the outcome of the visits put my plans not on pause, but in slow mo’.
First off I went to TBMP for the recommended HyCoSy (tubal patency test to make sure my fallopian tubes are clear prior to IUI) and Aquascan (to get a better view of the outline of my uterus) and my last post gives all the details on how that went.

Seconly, I went for the much anticipated consultation with a consultant at ACU (let’s call him Dr E). Having had a scan the day before (and bringing the report and US photos with me) plus all the previous investigations the appointment got off to a quick start. We talked through my medical history and then Dr E did a scan of his own… and my follicle had collapsed! I ovualted!!!!!!! 

Alongside the collapsed follicle there were also a number of smaller follicles so he said it looks like I actually have poly-cystic ovaries (not to be confused with PCOS – Polycystic Ovarian Syndrome); this isn’t a major concern though however it might indicate that ovulation isn’t as regular as we’d like.

The other thing he noted was that the uterine lining was only 6.5mm and at this stage in my cycle it should have been 8-10mm so I still have that problem.  It looks like the thin lining is actually my primary issue not irregular ovulation, because whether I ovulate naturally or we induce ovulation with meds, if my lining isn’t thick enough then an embryo won’t be able to implant (or even if it did it’s very unlikely the pregnancy would be viable is the lining can’t support the developing embryo/foetus).

The thin lining is what would be causing me to have these ridiculously short periods, because my periods seem to have gone back to being “regular” in terms of start date and it seems that the missed periods in September and October were probably a blip. I definitely need to get the hysteroscopy done so the doctors can take a proper look at the uterine lining and figure out if there’s anything untoward (e.g. scarring) that would be preventing the lining building up, and remove the polyp.

The doc also mentioned 3 other things that he’d need to see before I could start treatment with donor sperm; so all in all there are 5 issues to overcome on the check-list:

1. The poly-cystic ovaries – not a major concern and shouldn’t prevent me trying a natural cycle if ovulation is regular, otherwise ovulation can be induced.
2. The thin uterine lining – the biggest hurdle to overcome… more investigation required
3. Counselling – It’s mandatory that all people getting treated with donor sperm have “implications counselling” (I already did it at TBMP but ACU has to do it themselves as well) and they also need to do a “Welfare of the child assessment” which is done by discussion in the counselling session. The doc will ask the counselling team to call me and that shouldn’t cause any major delay.
4. Medical specialist consent – I have a mental health condition. It’s well managed at the moment, but the doctor will need to see a letter from my GP?mental health team confirming that they’re happy for me to go ahead. This is obviously in my best interest and also part of the welfare of the child assessment. In fact I’m very surprised that TBMP didn’t ask for this… I guess that’s a difference between a fully private clinic and an NHS clinic that has a much more rigorous set of procedures. Luckily I actually have an appointment with the perinatal mental health team tomorrow! [Obviously I’ll update afterwards]
5. Lose weight – I knew I’d put on a bit but I was horrified when I was weighed and my BMI was calculated as 34! Yuck!! The doc said I need to get it under 30 before I could go ahead with treatment. This means I need to lose at least 27lbs/12kg; I plan to lose a bit more than that since I’ll obviously put on weight when pregnant, so I’m aiming to lose 35lb/16kg.

So, the thin uterine lining is the biggest medical hurdle to overcome but it’s really the weight loss that’s going to slow this process down.
The doc says realistically he thinks it’ll take 6 months. I’m hoping to do it in 4, but then I’ll have to maintain the weight for a good 6 weeks before starting treatment. So things are in slow motion – while I get serious about this weight loss (GP has referred me to Weight Watchers for free)  I can be getting the hysteroscopy, counselling and anything else that comes up all sorted.

All in all I liked Dr E and I think I’m definitley going to use ACU as opposed to TBMP. Dr E advised that since IUI is a lot less involved than IVF I’d be treated by a team, not a specific doctor… on that basis there’s not point paying extra for the “personalised care” route rather than just “self funding”. Obviously that makes even more of a difference to cost so I really can’t justify going to Harley Street!